The present invention relates to a therapy and training device for the shoulder joint with a trunk base having two shoulder extensions on a rotational joint base, respectively associated with a shoulder, rotational around a vertical axis of a rotational shoulder joint means, having respectively spaced apart from the rotational joint base an arm extension for connection with an arm, which is rotationally connected with the shoulder extension around a transverse axis by an upper arm rotational joint means, wherein the shoulder extensions and/or the arm extension are coupled together for movement such that a rotational movement of one shoulder extension, or respectively, of an arm extension causes a rotational movement of the other shoulder extension, or respectively, of the other arm extension.
Therapy and training devices utilized for the treatment of movement constraints in an extremity and based on the principle that through the movement of the healthy extremity a movement of the extremity restricted in its mobility is induced, have so far been used for therapy and mobility training of knee joint. Such a therapy and training device is, for example, known from DE 195 09 465 A1. The known therapy and training device serves to treat movement constraints on a knee joint and, due to the substantially single-axis joint form of the knee joint, is relatively simply equipped with only a rotational joint means which connects a lower leg receptacle and an upper leg receptacle as a joint, wherein in therapy operation ideally the rotational axis of the rotational joint means corresponds with the knee joint axis of the patient.
Whereas in practice there is a particularly great need for rehabilitation with regard to movement constraints on the knee joint due to the frequency of knee injuries and associated knee operations, movement constraints on joints, however, generally are always ascertained when a prolonged immobilization of the joint was necessary after a surgical procedure. This also applies in particular with shoulder injuries or surgical procedures on the shoulder which can lead to considerable restrictions in movement in the shoulder region. Based on the complexity of the joint situation in the shoulder area, it is not possible, however, to use the known therapy and training device for a corresponding therapy of a shoulder joint.
From FR-A-1257 091 a therapy and training device for the shoulder joint is known, having a trunk base, which has on a rotational joint base two shoulder extensions, respectively associated with a shoulder, rotationally coupled by means of a rotational joint means. The shoulder extensions, respectively spaced apart from the rotational joint base, are provided with an arm extension, which is rotationally connected with the shoulder extension around a transverse axis by a upper arm rotational joint means. The arm extensions are coupled in movement such that a rotational movement of an arm extension causes a rotational movement of the other arm extension.
From FR-A-2 789 304 a device is known for the passive mobilization of the upper limbs with different motor means for the prompting of movement drive of a patient""s arm.
U.S. Pat. No. 5,613,928 shows a training device with two arm handles coupled in movement for muscle training.
From U.S. Pat. No. 4,971,040 a portable massage chair is known for performing massage therapy in any location.
The object of the present invention is to propose a therapy and training device that enables the performance of a complex movement treatment for the shoulder joint.
This object is achieved by therapy and training device exhibiting the features of claim 1.
In the therapy and training device according to the invention, the rotational joint means is formed as a rotational shoulder joint means such that the shoulder extensions are rotational around a vertical axis of the rotational shoulder joint means and are coupled in movement such that a rotational movement of the one shoulder extension causes a rotational movement of the other shoulder movement.
The configuration of the therapy and training device according to the invention particularly takes into account the shoulder anatomy, leading to the fact that shoulder movements, as a rule, induce arm or at least upper arm movements and vice versa. For example, already a simple forward and backward movement of a shoulder is combined with even a slight rotational movement of the upper arm. Such complex interrelationships of movement require a corresponding joint configuration on the therapy and training device. For the forward and backward movement, thus, the formation of a vertical axis on the therapy and training device is necessary which is arranged preferably adjacent to the shoulder base. In order to enable the overlapping rotational movement of the upper arm with the forward and backward movement, the formation of a rotating axis running correspondingly transverse to the vertical axis is required, which enables a so-called ante- and retro-version of the arm, therefore a forward and backward swinging.
The forward and backward movement of the shoulder blade with the overlapping forward and backward movement of the arm is enabled by the shoulder extension, formed as a joint lever, enabling a connection between the shoulder rotational joint means and the upper arm rotational joint means, thus, between the vertical axis and the transverse axis. To transmit the rotational movement executed on one side of the body by the shoulder blade or the arm or both to the other side of the body, the shoulder extension respectively associated with the other side of the body, or respectively, the arm extension associated with the other side of the body is respectively coupled in movement with its corresponding counterpart.
Particularly for the repositioning of the therapy and training device relative to the upper body of the patient, it is advantageous when a positioning means for the relative positioning vis-a-vis the spinal column of the patient is associated with the rotational joint base. Through this, it is possible to position the therapy and training device to the upper body of the patient without requiring an adjustment of the joint configuration of the therapy and training device to the individual anatomy of the patient even after an interruption of therapy and for the resumption of therapy.
A particularly direct manner of positioning results when the positioning means has a neck receptacle, adjustable in height, arranged on the rotational joint base along the trunk base. The neck receptacle, furthermore, also provides a possibility to prevent voluntary or involuntary avoidance movements of the upper body during the operation of the therapy and training device which could negatively affect, in particular, the desired adjustment of the joint configuration of the to therapy and training device to the individual anatomy of the patient. In principle, of course, other correspondingly effective means can be provided.
When the arm extension on the therapy and training device comprises an upper arm extension and a lower arm extension, wherein the upper arm extension is connected to the shoulder extension via the upper arm rotational joint means and the lower arm extension via an elbow joint means comprising at least a rotational axis is connected to the upper arm extension, it is possible to also integrate lower arm movements. For this purpose, relative movements in the simplest form of the lower arm compared to the upper area are sufficient, without having to transmit the movements of the lower arm extension like the movements of the upper arm extension and of the shoulder extension on the other side of the body in movement-coupled manner. Since relative movements of the lower arm can often be performed without restrictions compared to the upper arm with a shoulder restricted in movement, a corresponding coupling of the movement of the lower arm extensions of both sides can be omitted. Since, on the other hand, however, changed relative positions of the lower arm compared to the upper arm due to the associated displacement of mass can very well affect movements of the shoulder, the relative mobility of the lower arm extension can positively affect the success of therapy.
In addition, when the elbow joint means has two rotational axes, wherein a vertical axis runs transverse to the longitudinal extension of the upper arm extension and a transverse axis runs in the direction of the longitudinal extension of the upper arm extension, a coaxial joint means is formed which substantially corresponds to the actual anatomical proportions on the elbow joint.
Further, when the connection of the arm extension with an arm takes place by means of a connecting means arranged on the lower arm extension, e.g. longitudinal rotations of the upper arm compared to the upper arm extension are readily possible. For that reason, for example, it can be dispensed with forming the upper arm rotational joint means such that also longitudinal rotations of the upper arm extension are possible.
In a particularly advantageous embodiment of the therapy and training device at least one lower arm extension is provided with an actuating means to trigger a locking device operative on the upper arm rotational joint means, wherein an actuation of the actuating means results when the associated lower arm is released from its connection with the lower arm extension. Through this, a kind of xe2x80x9cemergency switchxe2x80x9d is realized which prevents that movements are performed by the unsound shoulder which are not performed by the sound extremity of the opposite side, or respectively, the sound shoulder, so that, for example, the unsound arm after a release of the connection of the lower arm of the sound side with the lower arm extension cannot fall down as a result of gravity from an elevated position.
A possible embodiment of such an xe2x80x9cemergency switchxe2x80x9d can, for example, consist of a control knob provided with a switch is provided at the free end of the lower leg receptacle, in which the switch is actuated by a release of the handle.
If the upper arm extension can be adjusted in its operative length between the upper arm rotational joint means and the elbow joint means, it is possible to compensate deviations between the rotational axis of the upper arm rotational joint means and the actual rotational axis of the shoulder joint by appropriate adjustments in length, without having constraints in movement arise.
A particularly effective therapy for the rehabilitation of movement restrictions on an affected shoulder joint is possible, when for coupled movement at least the shoulder rotational joint means and the upper arm rotational joint means of a side of the body are coupled with respectively the shoulder rotational joint means and the upper arm rotational joint means of the other side of the body by means of a coupling means, such that a joint movement on one side of the body causes a defined joint movement of the corresponding joint means on the other side of the body. According to the form of the corresponding coupling means, the induced counter movement takes place conversely, inversely or also in a defined geared transmission or reduction ratio.
In order to be able to prevent, for example, undesired or even harmful movements, the joint means provided on the therapy and training device can be provided at least partially with means to restrict joint movements.
In a further possible embodiment, the coupling means for coupled movement of the shoulder rotational joint means is formed as a wheel gear, wherein the wheel gear can be formed as a friction gear or as a gearwheel.
In a further preferable embodiment, the coupling means for the coupled movement of the upper arm rotational joint means is formed as a traction mechanism or a pressure gear so that a transfer of force can ensue by cable or by hydraulic fluid.
A preferable modular form of the therapy and training device enabling an easy adjustment to the given proportions is given if the trunk base has a connecting means for connection with a seat frame or a seat in general.
The trunk base can also be provided with a seat so that a use of the therapy and training device is possible independent from any further local requirements.
It is particularly advantageous when the seat frame is arranged to open out on the trunk base.
The various features of novelty which characterize the invention are pointed out with particularity in the claims annexed to and forming a part of this disclosure. For a better understanding of the invention, its operating advantages and specific objects attained by its uses, reference is made to the accompanying drawings and descriptive matter in which a preferred embodiment of the invention is illustrated.